- Sedgwick (Milwaukee, WI)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for ... managing SIU investigations of complex fraud schemes involving providers, vendors, attorneys and others;...degree from an accredited college or university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI),… more
- Molina Healthcare (Milwaukee, WI)
- …with federal and state laws. Negotiates and services larger and more complex market/national/group-based providers in accordance with company standards in order to ... expectations * Evaluates, negotiates and supports larger and more complex market/national/group-based providers in compliance with company standards while meeting… more
- Centers for Independence (Milwaukee, WI)
- …and treatment plan addendums + Monitors client's Prior Authorization status submits new claims as necessary and responds to member's insurance providers as needed to ... and Families and Youngstar. + Assumes responsibility for the director in the absence of the director ....groups. + Partners with clients to identify and resolve complex or sensitive issues. + Helps create a work… more